A complaint was made that an oral
and maxillofacial surgeon did not provide the appropriate standard
of care. The complaint was on the basis that the provider did not:
(1) properly assess the state of the consumer's tooth; (2) remove
the tooth when this was appropriate; (3) properly treat the
consumer's tooth; (4) properly inform the consumer of all the
treatment options available to him, including the risks and
benefits of those options, prior to commencing treatment; (5)
properly explain to the consumer the reasons for the treatment
being unsuccessful and the consequences; and (6) properly
communicate with other providers involved in the consumer's
care.

The facts were that the consumer was
referred to an oral and maxillofacial surgeon as he had internal
resorption in a tooth. An apicectomy was performed removing the
apex of the tooth and the resorptive tissue, but the resorption at
the crown of the tooth was not treated and the tooth subsequently
required extraction. Prior to the complaint, the surgeon offered to
remove the tooth at no extra cost and refund half the fee for the
apicectomy, and made efforts to resolve the consumer's issues about
treatment.

The Commissioner reasoned, after
receiving independent expert advice from an oral and maxillofacial
surgeon, that:

(1) the apicectomy was appropriate
to treat the internal resorption provided a standard root filling
was subsequently completed - however, this was not completed

(2) the provider did not address the
areas of resorption in the vicinity of the crown end of the tooth,
which allowed the disease to spread

(3) it was not reasonable for the
oral and maxillofacial surgeon to assume that the referring dentist
would treat the resorption at the crown end of the tooth

(4) in the decision to perform the
apicectomy the provider gave too much weight to the consumer's wish
to keep his tooth.

The Commissioner held that the oral
and maxillofacial surgeon:

(1) breached Right 4(1) of the Code
in that he failed to a complete a standard root filling following
an apicectomy for internal resorption

(2) did not breach Right 6(1)(b) of
the Code because he provided the consumer with sufficient
information about the apicectomy and about the failure of the
treatment.

With regard to record keeping, the
Commissioner reminded the provider of the obligation under the Code
of Practice of the New Zealand Dental Association to keep
appropriate records and arrange adequate physical security of
records.

The Commissioner recommended that
the provider apologise and provide a full refund of the
consultation fee.